国际麻醉学与复苏杂志   2017, Issue (12): 10-10
    
阿片类药物成瘾的突触可塑性机制
任艺, 崔伟华, 韩如泉1()
1.首都医科大学附属北京天坛医院
The role of synaptic plasticity in the process of opioid addiction
 全文:
摘要:

背景 阿片类药物广泛应用于慢性疼痛治疗,其长期用药或药物滥用可能导致的成瘾等社会问题不容忽视。 目的 对突触可塑性在阿片类药物成瘾中的作用进行综述。 内容 突触可塑性是药物成瘾发生发展的重要分子机制。结构上,突触可塑性参与突触的形成、修饰、再分布和调整;功能上,表现为突触传递的长时程增强或长时程抑制。慢性吗啡暴露,可能通过激活细胞周期素依赖蛋白激酶5,引起FosB聚积,对腹侧背盖区、伏隔核、前额叶皮质、杏仁核、海马等脑区突触产生影响。吗啡成瘾动物海马区长时程增强与N-甲基-D-天门冬氨酸受体(N-methyl-D-aspartate receptors, NMDAR)和GluR2-AMPAR受体上调相一致。这些分子机制可能是多巴胺受体激活和表观遗传改变的原因。突触可塑性可能与吗啡成瘾的行为表现有关,如运动增强、刻板行为、药物渴求和反复摄取药物行为。 趋向 特定脑区突触可塑性与吗啡成瘾的行为学表现之间的关系尚需进一步明确。脑区特异性的突触可塑性阻断,可能为临床治疗阿片类药物成瘾提供新的靶点。

关键词: 突触可塑性;阿片类药物;成瘾
Abstract:

Background Opiates are widely used for treatment of chronic pain. It is noteworthy that its long-term application and abuse lead to addiction, a serious public health and social problem. Objective To review the roles of synaptic plasticity in the development and maintenance of opioid addiction. Content Synaptic plasticity is one of the major cellular events in the development of drug-addiction. Structurally, synaptic plasticity involves synapse formation, pruning, redistribution, and modification, and functionally it manifests as long-term potentiation(LTP) or long-term depression(LTD) of synaptic transmission. Chronic exposure to morphine was reported to modify synapses in the ventral tegmental area, the nucleus accumbens, the prefrontal cortex, the amygdala, and the hippocampus, probably through activating cycline-dependent kinase-5, which leads to the accumulation of FosB. The enhancement of LTP in the hippocampus in morphine addicted animals is concurred with upregulation of N-methyl-D-aspartate receptors(NMDAR) and GluR2-containing α-amino-3-hydroxy-5-methyl-isoxazole propionic acid receptors(AMPAR). These molecular events could be caused by dopamine receptor activation and epigenetic modulation. Synaptic plasticity may be related to behavioral phenotypes of morphine addiction, such as, enhanced locomotion, stereotypic behaviors, and drug seeking and intake behavior. Trend Further investigations are warranted to clarify whether synaptic plasticity in certain brain region(s) corelates with particular behavioral aspect(s) of morphine addiction. Location-specific disruption of synaptic plasticity could be new therapeutic strategies for opioid addiction.

Key words: Synaptic plasticity; Opiate; Addiction